Agreement

January 18, 2008

Everyone says that once you bring lawyers into the mix, things can get nasty. But what can you do? Some events in life require legal counsel and a proper agreement. So much is at stake for both parties; things no one thinks about in the “dreaming” stage. In our case, each party needed to retain a lawyer and we, the “intended parents” as we are now known, had to pay for all legal fees. So on top of the dreaded lawyers, there was the dreaded bill looming at the end of the line. Although I wouldn’t say that things got nasty, they did at some points get a bit dramatic and they definitely got very long and thus very expensive in the end. Regardless, the end product was consensus and we hope it will be worth every penny.

The four of us signed the final agreement last Monday (January 14) and celebrated with a bit of bubbly. Sheona is already on the pill to suppress her ovulation. Next week will be a busy one. On Monday (January 21), Sheona, Jon and I will go to her “Teaching Session”, as they call it, at the IVF Clinic. This is where we’ll get the rundown of all the drugs she will need to take, when to take what, and how to take them. Some are injectable, others are in pill form, or may be in suppositories... we’ll see. Then, on Thursday, Andrés and I will be going for our “Teaching Session” to get the same information, but for my particular set of drugs.

A lot of people complained to me last week about the medical details being too technical for them, so I’ll attempt to explain the process in layman’s terms, although it IS very technical and complex. We are making a baby after all. When I started researching the topic of surrogacy, I ended up at site and message boards that used cryptic abbreviations for everything and so I’ll spare you those and take the extra half a second it will take me to actually spell out “birth control pill”, for instance.

Anyways, here goes: when you make a baby in your own body, usually one of your ovaries produces one egg, your partner’s sperm fertilizes it in your body (in vivo as opposed to in vitro) and the fertilized egg implants in your uterine lining, which is thick and rich with nutrients at that point in your cycle, thanks to the hormones you naturally produce.

When you make a baby outside of your body, it is a very complex and expensive process, so to increase your chances of success, you need to make more than one egg. For this, you inject yourself with the same hormone you would naturally produce for the same purpose, only in greater quantity: FSH or follicle stimulating hormone. This stimulates both your ovaries to produce follicles (little “pimples” in the ovaries that each contain an egg inside). While these mature, you have to be closely monitored because you can over-produce eggs and that can be dangerous, so you wake up every morning at 6 am, drive to the clinic and get blood tests and ultrasounds. When the doctors are confident that they have enough eggs and that they are ripe enough, they retrieve them. I won’t go into details on this procedure, ‘cause it’s kind of scary... If you really want to know how they do it and you’re not squeamish, ask me personally and I’ll be glad to explain further while I cringe. This is the part that I’m most nervous about at this point.

Anyway, the eggs they retrieve will not all be good enough to fertilize, and those that are will not all thrive after fertilization; some will not survive the five days post fertilization, so even if they harvested 20 eggs, chances are we’d end up with a lot less embryos when the embryo transfer date arrives. The reason they wait for five days is that by then, the egg will have divided into a seventy to one hundred-cell “blastocyst”. Two days less and we’re talking only 8 cells. Isn’t that amazing? The embryos that don’t make it to that stage are probably not strong enough to implant, so transferring five day blastocysts increases your chances of success.

That is the end of our biological “job” in this process and the beginning of Sheona’s much longer one. While I’ve been stimulating my eggs, she’ll have been preparing her womb to receive the embryos. She’ll be doing that by taking estrogen, another hormone. After they retrieve my eggs, she’ll also have to take progesterone, a second hormone that helps the embryos latch on and stay there, until the pregnancy has completed the placenta, which will then take over that roll. The progesterone injections are apparently quite painful, as it is a thick oil that is injected into the muscle. More on that when the time comes.

I guess the most intriguing part for me was how they will sync our cycles to run the process of ovulation – fertilization – implantation as if it where in the same body, meaning that hormonally, we need to be in the exact same moment of the 28 day menstrual cycle. But, it seems this is the easiest part. They suppress our ovulation altogether, effectively putting us both on the same “day” of the cycle. Once there, they can play with us as they wish. They just give us the right hormones at the right times, and we’ll be mimicking one regular cycle in two separate bodies. I find this too cool.

To summarize, the next important dates are:

January 21: Sheona and Jon’s teaching session
January 24: Patty and Andrés’s teaching session
January 25: Patty and Sheona to start Lupron (ovulation suppressant)
February 8: Patty to start stimulation with Puregon (FSH) and Sheona to start preparing her uterus with estrogen.

After that, it will depend on how my ovaries react to the drugs. And I will of course keep you all posted on all the gory details.